Thursday 18 September 2008

mirror - My baby gave her twin cancer... in the womb

Weeks after she gave birth to two girls Alissa Dunn was dealt a double blow – in an incredibly rare case one of her daughters caught cancer from the other. Here she describes their fight..
When my two-month-old daughter Maddie’s stomach became bloated I didn’t think it was anything serious.
Even when she vomited, I thought it would be nothing more than a tummy upset. But at a check-up for Maddie and her identical twin sister Bella, the doctor told me she needed to go to hospital.
I began to fear the worst. And soon my fears were confirmed – Maddie had cancer.
But a few days later things got worse. Maddie had given it to her twin sister too, while they were both growing in my womb
I’d had a trouble-free pregnancy. Maddie and Isabella – who we call Bella – were born at 37-and-a-half weeks on July 4.
Isabella was born first at 4.28am, weighing 5lb 12oz. Then under 15 minutes later Maddie came along, weighing 5lb 8oz.
I had a feeling I was having boys so it was surreal when I saw these two perfect little girls. We already had a son, Isaiah, three, but I’d always wanted a girl so I felt our family was complete.
Just 24 hours later I took the girls home. They were very docile babies, and by eight weeks they were sleeping through the night.
Then, a few days before their two-month check-up, Maddie seemed a bit off-colour. Her tummy was slightly bloated and she vomited too.
The doctor prescribed drops, for wind, but she was still unwell at her check-up. The doctor said Maddie needed X-rays and I began to feel that something was horribly wrong.
On the way to the hospital I looked at my husband Michael, 32, and without thinking, I blurted out: ‘What if it’s cancer?’
I don’t know why it crossed my mind. But I clung to Bella while the doctors ran tests on Maddie.
A few hours later doctors broke devastating news.
Maddie had a neuroblastoma – a massive cancerous tumour in her abdomen. She was admitted to intensive care, where the doctors fussed round, covering her in tubes and wires as I willed her to pull through.
It was the worst moment of my life. I had to stay strong for Bella and Isaiah but all I could think about was Maddie lying in her tiny incubator.
Then, three days later, when she came to visit, I noticed that Bella’s tummy was swollen too. I couldn’t believe what I was seeing.
We rushed to tell the doctors straight away. I prayed there was no way lightning could strike twice.
But after countless tests, the doctors diagnosed Bella with cancer too.
It didn’t feel real.
The only difference was that while Maddie had a tumour, Bella didn’t. Her body was full of cancerous cells – in her bone marrow and blood, but not growing in a ball like Maddie’s. The doctors decided there was only one way it could have happened – Bella had ‘caught’ cancer from her sister through the placenta while they were still in the womb.
Because they shared the same blood, the cancer had passed between them. It was only the ninth recorded case of it happening in the world. The girls needed urgent treatment.
Maddie’s cancer was stage four – the worst kind.
I knew deep down what the prognosis could be, but it was still a shock when the doctors said that she only had a 20 per cent chance of survival.
Bella would have to go through chemotherapy too. All I could do was hope the doctors could mend their tiny bodies before the cancer took hold completely. They lay in intensive care surrounded by wires while I looked on helplessly.

Watching the girls fight it was agony. Worst of all I couldn’t pick them up because of risk of infection. And they were in so much pain that touching would have worsened it.
As their mum there was nothing I could do. I told myself I had to stay strong so they could take strength from me. I was sure they could feel my desperation, though.
And the girls were so amazing throughout they made us braver. No matter how much they were poked by the doctors, they would just cry for a second and then let the doctors get on with it. They were my inspiration.
But as their tufts of soft hair fell out from the chemo, my heart broke. I should have been watching my girls grow into toddlers, not waiting to find downy hair on their pillows.
While Isaiah stayed at home with my family, Michael, my mum and I lived in a special house for families with children at the hospital, so we could be close to the girls.
Maddie was on a ventilator because she couldn’t breathe on her own and they were both on big doses of morphine.
But I needed to be with Isaiah too. He was so young and needed his mum. And thankfully my mum, Lora, always stayed with the girls when I went home to see him.
One day, about three weeks after the girls were admitted, I came home and saw their babygrows in the airing cupboard.
I lost it. I screamed and cried, all my anger and fear pouring out.
I felt so cheated that these first weeks of their life were being snatched from me and that they might not ever make it home again.
Finally, 44 days later, the doctors said the girls were well enough to come home with us. I held them close as I carried them to the car.
They’d been through two gruelling rounds of chemo and still needed more anti-cancer drugs. But all that mattered was I could have them with me, in their room at our house in Grand Blanc, Michigan, USA.
Having them back home with us was amazing. Just being able to bathe and feed them was a joy. Though we did have to take the girls back to hospital for more treatment.
On December 20, 2007, we got the news I’d hoped so badly for. After four rounds of chemotherapy my little girls were cancer-free. It felt so amazing. I couldn’t believe they’d both beaten the cancer.
It’s a year on now, and both girls are doing well. Their hair has grown back, and they are both full of life.
They still need regular scans and blood and urine tests to check the cancer hasn’t returned, and it’s hard not to want to wrap them up in cotton wool.
They can both walk already – it’s such a change from seeing them lying in their hospital cots surrounded by wires – and as they totter around the house I feel so lucky.
Some people have asked me whether I’ll tell Maddie she ‘gave’ Bella cancer, and of course I will. It’s nothing to feel bad about – she had no control over it
And in a weird way I think it’s for the best that Bella got it too. Otherwise Bella couldn’t have been with Maddie through her treatment and I’m sure it was their incredible bond that gave Maddie the strength to fight.
Dr Bruce Morland, a consultant specialist in children’s cancer and the Chairman of Children’s Cancer and Leukaemia Group, says: “This is fantastically rare.
“Neuroblastoma is one of the more common tumours. But like leukaemia it’s blood borne and as identical twins share a blood supply and a placenta then it can be ‘caught’.
“However it’s a one-way stream, so the mother won’t catch it. It couldn’t happen with non identical twins as they don’t share a placenta or blood supply.
“Neuroblastoma is quite common among infants and it’s not uncommon to be diagnosed on a scan or early in a baby’s life. Fortunately the majority of infants with neuroblastoma can be cured.”

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